Intestinal microbiota changes in type 2 Diabetes mellitus patients, known impacts and future perspectives

Authors

DOI:

https://doi.org/10.33448/rsd-v11i8.31257

Keywords:

Type 2 Diabetes Mellitus; Intestinal microbiota; Prebiotics; Probiotics.

Abstract

The present literature review sought to identify how the pathophysiology of Type 2 Diabetes Mellitus impacts the intestinal microbiota, as well as the metabolic aspects of the intestinal microbiota may be associated with Type 2 Diabetes Mellitus, in addition to the usual and developing managements. For this, searches were carried out in databases to identify tests in human and animal models, where 28 studies were used for the development of this review. The studies used suggest that the intestinal microbiota of patients with type 2 diabetes mellitus has a role in the pathogenesis and progression of the disease, as well as the disease has an impact on the microbiota of the patient. Regarding management, the usability of drugs is directly associated with the pathogenesis and progression of the disease, without taking into account intestinal dysbiosis, whereas the usability of non-drugs is managed taking into account the pathogenesis and progression of the disease, associated pathways and microbiota. The use of prebiotics, probiotics and symbiotics is still in the development phase, and there is no consensus on how they can impact the disease and the intestinal microbiota of the carrier, nor what dosage can be indicated for management. Finally, more studies are needed, especially in humans, that can direct the usability of prebiotics, probiotics and symbiotics, both in the type of strain and in their dosage, taking into account factors such as age, sex and race.

Author Biography

Daniela de Araújo Medeiros Dias, Centro Universitário de Brasília

Master in Nutrition and Health Federal University of Goiás, Adjunct Professor at the University Center of Brasília – CEUB

References

Adeshirlarijaney, A., & Gewirtz, A. T. (2020). Considering gut microbiota in treatment of type 2 diabetes mellitus. Gut Microbes, 11(3), 253–264. https://doi.org/10.1080/19490976.2020.1717719

Balakumar, M., Prabhu, D., Sathishkumar, C., Prabu, P., Rokana, N., Kumar, R., Raghavan, S., Soundarajan, A., Grover, S., Batish, V. K., Mohan, V., & Balasubramanyam, M. (2016). Improvement in glucose tolerance and insulin sensitivity by probiotic strains of Indian gut origin in high-fat diet-fed C57BL/6J mice. European Journal of Nutrition, 57(1), 279–295. https://doi.org/10.1007/s00394-016-1317-7

Birkeland, E., Gharagozlian, S., Birkeland, K. I., Valeur, J., Måge, I., Rud, I., & Aas, A.-M. (2020). Prebiotic effect of inulin-type fructans on faecal microbiota and short-chain fatty acids in type 2 diabetes: a randomised controlled trial. European Journal of Nutrition, 59(7), 3325–3338. https://doi.org/10.1007/s00394-020-02282-5

Campos, L., Chaer, V., Hafez, B., Alves Barreto, P., Gonzalez, M., Duprat Ceniccola, G., Barbosa De Abreu, H., Tepedino, J., Alves, M., Andrade, N., Segadilha, L., Kumbier, M., & Castro, M. (2020). Brazilian Society of Parenteral and Enteral Nutrition BRASPEN JOURNAL Diretriz BRASPEN de Terapia Nutricional no Diabetes Mellitus. BRASPEN Journal, 35(4). https://www.braspen.org/_files/ugd/66b28c_77ee5a91b6d14ade864fe0c091afde8c.pdf

Cui, H.-X., Zhang, L.-S., Luo, Y., Yuan, K., Huang, Z.-Y., & Guo, Y. (2019). A Purified Anthraquinone-Glycoside Preparation From Rhubarb Ameliorates Type 2 Diabetes Mellitus by Modulating the Gut Microbiota and Reducing Inflammation. Frontiers in Microbiology, 10. https://doi.org/10.3389/fmicb.2019.01423

Gu, Y., Wang, X., Li, J., Zhang, Y., Zhong, H., Liu, R., Zhang, D., Feng, Q., Xie, X., Hong, J., Ren, H., Liu, W., Ma, J., Su, Q., Zhang, H., Yang, J., Wang, X., Zhao, X., Gu, W., & Wang, W. (2017). Analyses of gut microbiota and plasma bile acids enable stratification of patients for antidiabetic treatment. Nature Communications, 8(1). https://doi.org/10.1038/s41467-017-01682-2

Gurung, M., Li, Z., You, H., Rodrigues, R., Jump, D. B., Morgun, A., & Shulzhenko, N. (2020). Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine, 51, 102590. https://doi.org/10.1016/j.ebiom.2019.11.051

Hashimoto, Y., Nakajima, H., Hata, S., Miyoshi, T., Hosomi, Y., Majima, S., Nakanishi, N., Senmaru, T., Osaka, T., Okada, H., Ushigome, E., Hamaguchi, M., Asano, M., Yamazaki, M., & Fukui, M. (2020). Effect of probiotics, Bifidobacterium bifidum G9-1, on gastrointestinal symptoms in patients with type 2 diabetes mellitus: study protocol for open-label, single-arm, exploratory research trial (Big STAR study). Journal of Clinical Biochemistry and Nutrition, 67(3), 223–227. https://doi.org/10.3164/jcbn.20-100

Horvath, A., Leber, B., Feldbacher, N., Tripolt, N., Rainer, F., Blesl, A., Trieb, M., Marsche, G., Sourij, H., & Stadlbauer, V. (2019). Effects of a multispecies synbiotic on glucose metabolism, lipid marker, gut microbiome composition, gut permeability, and quality of life in diabesity: a randomized, double-blind, placebo-controlled pilot study. European Journal of Nutrition, 59(7), 2969–2983. https://doi.org/10.1007/s00394-019-02135-w

Kanazawa, A., Aida, M., Yoshida, Y., Kaga, H., Katahira, T., Suzuki, L., Tamaki, S., Sato, J., Goto, H., Azuma, K., Shimizu, T., Takahashi, T., Yamashiro, Y., & Watada, H. (2021). Effects of Synbiotic Supplementation on Chronic Inflammation and the Gut Microbiota in Obese Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study. Nutrients, 13(2), 558. https://doi.org/10.3390/nu13020558

Karuranga, S., Malanda, B., Saeedi, P., & Salpea, P. (2019). IDF diabetes atlas 463 people living with diabetes mellitus. https://diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdf

Karusheva, Y., Koessler, T., Strassburger, K., Markgraf, D., Mastrototaro, L., Jelenik, T., Simon, M.-C., Pesta, D., Zaharia, O.-P., Bódis, K., Bärenz, F., Schmoll, D., Wolkersdorfer, M., Tura, A., Pacini, G., Burkart, V., Müssig, K., Szendroedi, J., & Roden, M. (2019). Short-term dietary reduction of branched-chain amino acids reduces meal-induced insulin secretion and modifies microbiome composition in type 2 diabetes: a randomized controlled crossover trial. The American Journal of Clinical Nutrition, 110(5), 1098–1107. https://doi.org/10.1093/ajcn/nqz191

Kassaian, N., Aminorroaya, A., Feizi, A., Jafari, P., & Amini, M. (2017). The effects of probiotic and synbiotic supplementation on metabolic syndrome indices in adults at risk of type 2 diabetes: study protocol for a randomized controlled trial. Trials, 18(1). https://doi.org/10.1186/s13063-017-1885-8

Khalili, L., Alipour, B., Asghari Jafar-Abadi, M., Faraji, I., Hassanalilou, T., Abbasi, M., Vaghef-Mehrabany, E., & Sani, M. (2019). The Effects of Lactobacillus casei on Glycemic Response, Serum Sirtuin1 and Fetuin-A Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Iranian Biomedical Journal, 23(1), 68–77. https://doi.org/10.29252/.23.1.68

Li, H.-Y., Zhou, D.-D., Gan, R.-Y., Huang, S.-Y., Zhao, C.-N., Shang, A., Xu, X.-Y., & Li, H.-B. (2021). Effects and Mechanisms of Probiotics, Prebiotics, Synbiotics, and Postbiotics on Metabolic Diseases Targeting Gut Microbiota: A Narrative Review. Nutrients, 13(9), 3211. https://doi.org/10.3390/nu13093211

McMurdie, P. J., Stoeva, M. K., Justice, N., Nemchek, M., Sieber, C. M. K., Tyagi, S., Gines, J., Skennerton, C. T., Souza, M., Kolterman, O., & Eid, J. (2022). Increased circulating butyrate and ursodeoxycholate during probiotic intervention in humans with type 2 diabetes. BMC Microbiology, 22(1). https://doi.org/10.1186/s12866-021-02415-8

Ministério da Saúde. (2020). Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no distrito federal em 2019. https://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2019_vigilancia_fatores_risco.pdf

Motiani, K. K., Collado, M. C., Eskelinen, J.-J., Virtanen, K. A., Löyttyniemi, E., Salminen, S., Nuutila, P., Kalliokoski, K. K., & Hannukainen, J. C. (2019). Exercise Training Modulates Gut Microbiota Profile and Improves Endotoxemia. Medicine & Science in Sports & Exercise, 52(1), 94–104. https://doi.org/10.1249/mss.0000000000002112

Palacios, T., Vitetta, L., Coulson, S., Madigan, C. D., Lam, Y. Y., Manuel, R., Briskey, D., Hendy, C., Kim, J.-N., Ishoey, T., Soto-Giron, M. J., Schott, E. M., Toledo, G., & Caterson, I. D. (2020). Targeting the Intestinal Microbiota to Prevent Type 2 Diabetes and Enhance the Effect of Metformin on Glycaemia: A Randomised Controlled Pilot Study. Nutrients, 12(7), 2041. https://doi.org/10.3390/nu12072041

Pedersen, C., Gallagher, E., Horton, F., Ellis, R. J., Ijaz, U. Z., Wu, H., Jaiyeola, E., Diribe, O., Duparc, T., Cani, P. D., Gibson, G. R., Hinton, P., Wright, J., La Ragione, R., & Robertson, M. D. (2016). Host–microbiome interactions in human type 2 diabetes following prebiotic fibre (galacto-oligosaccharide) intake. British Journal of Nutrition, 116(11), 1869–1877. https://doi.org/10.1017/s0007114516004086

Ren, M., Zhang, H., Qi, J., Hu, A., Jiang, Q., Hou, Y., Feng, Q., Ojo, O., & Wang, X. (2020). An Almond-Based Low Carbohydrate Diet Improves Depression and Glycometabolism in Patients with Type 2 Diabetes through Modulating Gut Microbiota and GLP-1: A Randomized Controlled Trial. Nutrients, 12(10), 3036. https://doi.org/10.3390/nu12103036

Sato, J., Kanazawa, A., Azuma, K., Ikeda, F., Goto, H., Komiya, K., Kanno, R., Tamura, Y., Asahara, T., Takahashi, T., Nomoto, K., Yamashiro, Y., & Watada, H. (2017). Probiotic reduces bacterial translocation in type 2 diabetes mellitus: A randomised controlled study. Scientific Reports, 7(1). https://doi.org/10.1038/s41598-017-12535-9

Scheithauer, T. P. M., Rampanelli, E., Nieuwdorp, M., Vallance, B. A., Verchere, C. B., van Raalte, D. H., & Herrema, H. (2020). Gut Microbiota as a Trigger for Metabolic Inflammation in Obesity and Type 2 Diabetes. Frontiers in Immunology, 11. https://doi.org/10.3389/fimmu.2020.571731

Sociedade Brasileira de Diabetes. (2020). Diretrizes Sociedade Brasileira de Diabetes 2019 - 2020. http://www.saude.ba.gov.br/wp-content/uploads/2020/02/Diretrizes-Sociedade-Brasileira-de-Diabetes-2019-2020.pdf

Su, L., Hong, Z., Zhou, T., Jian, Y., Xu, M., Zhang, X., Zhu, X., & Wang, J. (2022). Health improvements of type 2 diabetic patients through diet and diet plus fecal microbiota transplantation. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-05127-9

Takewaki, F., Nakajima, H., Takewaki, D., Hashimoto, Y., Majima, S., Okada, H., Senmaru, T., Ushigome, E., Hamaguchi, M., Yamazaki, M., Tanaka, Y., Nakajima, S., Ohno, H., & Fukui, M. (2021). Habitual Dietary Intake Affects the Altered Pattern of Gut Microbiome by Acarbose in Patients with Type 2 Diabetes. Nutrients, 13(6), 2107. https://doi.org/10.3390/nu13062107

Tian, P., Li, B., He, C., Song, W., Hou, A., Tian, S., Meng, X., Li, K., & Shan, Y. (2016). Antidiabetic (type 2) effects of Lactobacillus G15 and Q14 in rats through regulation of intestinal permeability and microbiota. Food & Function, 7(9), 3789–3797. https://doi.org/10.1039/c6fo00831c

Toejing, P., Khat-Udomkiri, N., Intakhad, J., Sirilun, S., Chaiyasut, C., & Lailerd, N. (2020). Putative Mechanisms Responsible for the Antihyperglycemic Action of Lactobacillus paracasei HII01 in Experimental Type 2 Diabetic Rats. Nutrients, 12(10), 3015. https://doi.org/10.3390/nu12103015

Tong, X., Xu, J., Lian, F., Yu, X., Zhao, Y., Xu, L., Zhang, M., Zhao, X., Shen, J., Wu, S., Pang, X., Tian, J., Zhang, C., Zhou, Q., Wang, L., Pang, B., Chen, F., Peng, Z., Wang, J., & Zhao, L. (2018). Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial. mBio, 9(3). https://doi.org/10.1128/mbio.02392-17

Tonucci, L. B., Olbrich dos Santos, K. M., Licursi de Oliveira, L., Rocha Ribeiro, S. M., & Duarte Martino, H. S. (2017). Clinical application of probiotics in type 2 diabetes mellitus: A randomized, double-blind, placebo-controlled study. Clinical Nutrition, 36(1), 85–92. https://doi.org/10.1016/j.clnu.2015.11.011

Vallianou, N. G., Stratigou, T., & Tsagarakis, S. (2019). Metformin and gut microbiota: their interactions and their impact on diabetes. Hormones, 18(2), 141–144. https://doi.org/10.1007/s42000-019-00093-w

Wang, S., Ren, H., Zhong, H., Zhao, X., Li, C., Ma, J., Gu, X., Xue, Y., Huang, S., Yang, J., Chen, L., Chen, G., Qu, S., Liang, J., Qin, L., Huang, Q., Peng, Y., Li, Q., Wang, X., & Wang, W. (2021). Combined berberine and probiotic treatment as an effective regimen for improving postprandial hyperlipidemia in type 2 diabetes patients: a double blinded placebo controlled randomized study. Gut Microbes, 14(1). https://doi.org/10.1080/19490976.2021.2003176

Wang, Y., Dilidaxi, D., Wu, Y., Sailike, J., Sun, X., & Nabi, X.-h. (2020). Composite probiotics alleviate type 2 diabetes by regulating intestinal microbiota and inducing GLP-1 secretion in db/db mice. Biomedicine & Pharmacotherapy, 125, 109914. https://doi.org/10.1016/j.biopha.2020.109914

Wei, S., Brejnrod, A. D., Trivedi, U., Mortensen, M. S., Johansen, M. Y., Karstoft, K., Vaag, A. A., Ried-Larsen, M., & Sørensen, S. J. (2021). Impact of intensive lifestyle intervention on gut microbiota composition in type 2 diabetes: a post-hoc analysis of a randomized clinical trial. Gut Microbes, 14(1). https://doi.org/10.1080/19490976.2021.2005407

Wen, L., & Duffy, A. (2017). Factors Influencing the Gut Microbiota, Inflammation, and Type 2 Diabetes. The Journal of Nutrition, 147(7), 1468S—1475S. https://doi.org/10.3945/jn.116.240754

Woldeamlak, B., Yirdaw, K., & Biadgo, B. (2019). Role of Gut Microbiota in Type 2 Diabetes Mellitus and Its Complications: Novel Insights and Potential Intervention Strategies. The Korean Journal of Gastroenterology, 74(6), 314. https://doi.org/10.4166/kjg.2019.74.6.314

World Health Organization. (2021, November 10). Diabetes. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/diabetes

Wu, H., Esteve, E., Tremaroli, V., Khan, M. T., Caesar, R., Mannerås-Holm, L., Ståhlman, M., Olsson, L. M., Serino, M., Planas-Fèlix, M., Xifra, G., Mercader, J. M., Torrents, D., Burcelin, R., Ricart, W., Perkins, R., Fernàndez-Real, J. M., & Bäckhed, F. (2017). Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug. Nature Medicine, 23(7), 850–858. https://doi.org/10.1038/nm.4345

Zhang, L., Chu, J., Hao, W., Zhang, J., Li, H., Yang, C., Yang, J., Chen, X., & Wang, H. (2021). Gut Microbiota and Type 2 Diabetes Mellitus: Association, Mechanism, and Translational Applications. Mediators of Inflammation, 2021, 1–12. https://doi.org/10.1155/2021/5110276

Zhang, W., Xu, J.-H., Yu, T., & Chen, Q.-K. (2019). Effects of berberine and metformin on intestinal inflammation and gut microbiome composition in db/db mice. Biomedicine & Pharmacotherapy, 118, 109131. https://doi.org/10.1016/j.biopha.2019.109131

Zhang, Y., Gu, Y., Ren, H., Wang, S., Zhong, H., Zhao, X., Ma, J., Gu, X., Xue, Y., Huang, S., Yang, J., Chen, L., Chen, G., Qu, S., Liang, J., Qin, L., Huang, Q., Peng, Y., Li, Q., & Wang, W. (2020). Gut microbiome-related effects of berberine and probiotics on type 2 diabetes (the PREMOTE study). Nature Communications, 11(1). https://doi.org/10.1038/s41467-020-18414-8

Zhao, L., Zhang, F., Ding, X., Wu, G., Lam, Y. Y., Wang, X., Fu, H., Xue, X., Lu, C., Ma, J., Yu, L., Xu, C., Ren, Z., Xu, Y., Xu, S., Shen, H., Zhu, X., Shi, Y., Shen, Q., & Dong, W. (2018). Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes. Science, 359(6380), 1151–1156. https://doi.org/10.1126/science.aao5774

Zheng, Y., Ley, S. H., & Hu, F. B. (2017). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88–98. https://doi.org/10.1038/nrendo.2017.151

Zhou, T., Heianza, Y., Chen, Y., Li, X., Sun, D., DiDonato, J. A., Pei, X., LeBoff, M. S., Bray, G. A., Sacks, F. M., & Qi, L. (2019). Circulating Gut Microbiota Metabolite Trimethylamine N-Oxide (TMAO) and Changes in Bone Density in Response to Weight Loss Diets: The POUNDS Lost Trial. Diabetes Care, 42(8), 1365–1371. https://doi.org/10.2337/dc19-0134

Published

26/06/2022

How to Cite

OLIVEIRA, E. C. D. de; GUIMARÃES, L. M. K. .; DIAS, D. de A. M. Intestinal microbiota changes in type 2 Diabetes mellitus patients, known impacts and future perspectives . Research, Society and Development, [S. l.], v. 11, n. 8, p. e48311831257, 2022. DOI: 10.33448/rsd-v11i8.31257. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/31257. Acesso em: 25 apr. 2024.

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Section

Review Article